RT Book, Section
A1 Shinkai, Kanade
A1 Fox, Lindy P.
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1184189912
T1 Dermatitis Herpetiformis
T2 Current Medical Diagnosis & Treatment 2022
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264269389
LK accessmedicine.mhmedical.com/content.aspx?aid=1184189912
RD 2024/04/19
AB Dermatitis  herpetiformis  is  an  uncommon  disease  manifested  by  pruritic  papules,  vesicles,  and  papulovesicles  mainly  on  the  elbows,  knees,  buttocks,  posterior  neck,  and  scalp  (eFigure  6–54).  It  appears  to  have  its  highest  prevalence  in  Northern  Europe  and  is  associated  with  HLA  antigens  -B8,  -DR3,  and  -DQ2.  The  histopathology  is  distinctive.  Circulating  antibodies  to  tissue  transglutaminase  are  present  in  90%  of  cases.  NSAIDs  may  cause  flares.  Patients  have  gluten-sensitive  enteropathy,  but  nondermatologic  disease  is  subclinical  in  the  great  majority.  However,  ingestion  of  gluten  is  the  cause  of  dermatitis  herpetiformis,  and  strict  long-term  avoidance  of  dietary  gluten  may  eliminate  the  need  for  treatment  or  decrease  the  dose  of  dapsone  (initial  treatment  dose  is  100–200  mg  orally  daily)  required  to  control  the  disease.  Patients  with  dermatitis  herpetiformis  are  at  increased  risk  for  development  of  gastrointestinal  lymphoma,  and  this  risk  is  reduced  by  a  gluten-free  diet.